Surgical Management of Concurrent Medial Patellar Luxation and Cranial Cruciate Ligament Rupture in a Chihuahua Crossbreed Dog

A 4-year-old Chihuahua crossbreed dog was presented with chronic left hind limb lameness acutely exacerbated following a traumatic incident 45 days prior to presentation. Orthopedic examination revealed grade 3 medial patellar luxation with a shallow trochlear groove, tibial internal rotation, and a positive cranial drawer sign indicated concurrent cranial cruciate ligament rupture. Radiographic evaluation confirmed a shallow trochlear groove, internal tibial rotation, a fat pad sign indicating joint effusion, and mild osteoarthritis. Due to financial constraints, the owner declined advanced diagnostic imaging (arthroscopy or MRI) as well as tibial plateau leveling osteotomy. Surgical intervention was performed combining tibial tuberosity transposition with tension band wiring, trochlear wedge recession, and lateral fabellar extracapsular stabilization using 80 lbs nylon suture. Postoperative recovery was uneventful, with marked improvement in lameness and stifle stability at 12-day follow-up. This case demonstrates that combined extracapsular stabilization and patellar realignment can be a viable and cost-effective surgical approach for managing concurrent medial patellar luxation and cranial cruciate ligament rupture in small dog breeds when advanced osteotomy techniques are not feasible.